Immunotherapy as a Treatment Modality for Mucosal Melanomas of the Head
and Neck: A Systematic Review
Abstract
Abstract Introduction Mucosal melanoma (MM) is a rare disease,
accounting for approximately 1.4% of all melanomas and only 0.03% of
all new cancer diagnoses [1]. Traditionally, it is associated with a
poor prognosis with an overall 5-year survival rate of less than
25%[1]. Progress in treatment has been hindered by rarity and lack
of evidence. Studies however of treatment of subcutaneous melanoma with
immunotherapy have demonstrated a significant improvement in survival
rates and have become a core part of oncological strategy. This paper
will discuss revision of the evidence for the use of immunotherapy in
the Head and Neck. Design A systematic review was conducted on
19/01/2019. Medline and Embase databases were searched. 509 articles
were collated, of which 52 met the inclusion criteria. Results Results
were shown as a comparison of yearly survival rates following different
treatment modalities (immunotherapy vs non-immunotherapy) at 2 years, 3
years, and 5 years respectively. Conclusions Immunotherapy outcomes in
small studies have shown good data for increasing survival rates at all
yearly intervals in MM of the head and neck. Larger clinical trials
should be done to accurately distinguish efficacy and survival outcomes
of immunotherapy when compared to treatment modalities excluding
immunotherapy. The ability to perform larger trials are, however,
limited by the rarity of MM of the head and neck.